If visual therapy could be beneficially presented to a patient in his everyday environment (not just in a doctor's office) and still enable the patient to enjoy a reasonably normal life style for eight hours a day during treatment, perhaps one could radically speed up the cure and reduce vision therapy dropouts. This invention will speed up such vision therapy. Out of necessity, to place spinning optics into perspective as a therapeutic tool, some of the present problems in modern orthoptics should be discussed. Three hours a week is probably the maximum vision training exposure for most optometric patients. One week of spinning optics treatment might be equivalent to four and a half months of conventional therapy given the appropriate technology. Fifty-six hours of spinning optics training per week must become possible, assuming training eight hours a day, seven days a week if optometric vision training is to reach the large number of persons that need and can benefit from it.
Spinning optics is of course not new. Daily ophthalmic examination uses spinning optics including a Risley prism where two prisms are aligned at ortho with base-apex of one prism in conjunction with the apex-base of the other. In this system, one prism moves while the other remains relatively constant.
Also commonplace are the rotational effects of contact lenses and the value of prism ballasting for stabilizing toric lenses and bifocal contacts. A number of examples in orthoptics quickly come to mind, though not in the proper chronological sequence. Foremost stands the contribution of Mandaville of Florida, with his Binoculator. The Mandaville apparatus electrically and mechanically rotates prisms and filters monocularly and binocularly. Mandaville mechanically induces variable education movements of the eyes by step-rotating moving prisms before non-moving prisms. Using a fixed steroscopic lens with rotating prism lenses, it was possible to rotate binocularly fused stereoscopic cards.
The second important innovator was Genevay of New Orleans, who developed a portable rotating Risley prism powered by a small motor with batteries in a flashlight handle. They could be obtained in pairs and one suggested use was for the purposeful induction of diplopia to make it possible for a patient to use his normal suppression mechanism.
Certain entopic phenomenon, both in testing and training, utilize spinning optics. Haidinger brushes uses a rotating polaroid sheet with a blue violet filter. The patient then sees a rotating propeller effect because of Henle's Loop at the fovea. The Rinaldi-Larson Macula Scope is an handheld battery operated version. Maxwell's spot also has been used to distinguish between pathological affectations of the fovea. A purple filter is used and a red spot on a purple background is observed.
M. Allen, of the University of Indiana, has suggested the use of a rotating polaroid and anaglyph material in his Fusionaider. Recently, he has proposed electronically powering a lightweight material resembling a paddle to alternately occlude patient's eyes. The occluder travels within a fixed arc and then reverses direction.
Allen's TBI or Translid Bonocular Integrator takes advantage of alpha rhythm and apparent movement along the horizontal axis to break central suppressions.
Kirschner has suggested rotation of movies and cartoons on the wall as a motivating stimulant in vision training. Kirschner also developed a test which requires a patient to wear a miner's headlamp and follow a spinning or rotating target. Use of anaglyphs with appropriate colored rotating lights gives anti-suppression controls.
Critical Flicker Fusion (CFF) though not clinically used often today in optometry has involved spinning filters.
Arneson, with his rotator for visual training used red reflecting lights for a patient to follow in version training.
Also, in psychology, the Archimedes Spiral Rotator has been used in the induction of illusion of reversed rotation and hypnosis. Color wheels have been used for years to determine hue and saturation.
Thus, the literature is replete with many references to spinning instruments, but there is historically little research on driving spheres, cylinders, prisms, and color filters in front of a patient's eyes. This is certainly not surprising, since few researchers have appreciated the value of such spinning. Rather than being a disadvantage, it is herein proposed to utilize the phenomenon advantageously.
The following U.S. Pat. Nos. appear to be germane to the subject matter of the present invention:
2,718,227 Powell; PA1 3,168,894 Hollander; PA1 3,484,155 Praeger et al; PA1 3,493,989 Allen; PA1 3,544,203 Garcia. PA1 A. Monocular=versions and rotations, fixations and accomodation. Fixation or versions are movements vertically, horizontally, or obliquely using combinations of such movement. Rotations are circular movements or arcing translatory movements within a 360.degree. circle. Accommodation is any activity using the muscles of accommodation for stimulation, or inhibition or the focusing apparatus. PA1 B. Unfused dissociated=versions, rotations, fixations, and accommodation. PA1 C. Alternating=versions, rotations, fixations and accommodative skill training. PA1 D. Brief overlapping momentary bi-ocular=versions, rotations, fixations and accommodative rock. PA1 E. Binocular=versions, rotations, fixations, and accommodative rock. PA1 F. Rotation with stereoscopic fusion can be performed with spinning optics. A patient can fuse AN and Bu stereoscopic cards or BO (base out) and BI (base in) reading paragraphs while adding a rotational or spinning component to his training. Control marks and plus and minus lenses can be used to compensate for the optical distance when accommodation occurs. Use of anaglyph or polaroid utilizing crossed and uncrossed diplopia created the necessary disparity. PA1 G. Cheiroscopic training can be accomplished during a stage where overlapping and dissimilar images are attempted to be fused. Here the patient attempts to trace in the air, with the finger, the superimposed target from a sideways projected image. A drive motor stops and starts for an appropriate time so the patient's drawing can be completed. A spinning mirror also can be used to move the projected target anywhere within 360.degree. for tracing PA1 H. Tachistoscopic effects from spinning optics have already been mentioned. Using various materials like variable apertures, and simultaneously combining spinning and non-spinning polaroid filters have enabled us to alter our exposure times to certain moving stimuli. PA1 I. Fixations and rotations using yoked prisms.--Obviously, rotational or translatory effect are quite easy to achieve when an instrument can rotate 360.degree.. Yoked prisms are used under two-eyed conditions not to create diplopia but to simultaneously and equally displace the image. Displacement occurs when light has parallel, corresponding locations on the retina. Diplopia occurs with non-parallel, non-corresponding retinal locations. Yoked prisms are a method of creating light displacement but not diplopia when prisms are split between two eyes whose base apex lines are coincident, but whose bases are parallel and both point in a common visual direction to each other. There are two types of yoked prisms which can be made with fresnel optics: PA1 J. Electronic Ductions--attempts with a spinning optics device to create simultaneous extended two-eyed movement of the patient's eyes from their original position without creating diplopia. After reaching a certain stopping point, whether diplopia is created or not, electronically ocular movement can be restored back to its earlier binocular single vision state.
Hollander teaches the use of a vision trainer in which light bulbs for each eye are pulse varied by timers which are also provided with means to control the light intensity for illuminating targets.
Powell teaches the use of a visual exercising device in which a light bulb array, whose firing sequence may be altered, provides the exercise.
The remaining references show the state of the art further. None of the references cited contemplates a structural or conceptual framework substantially similar to the present invention.
There are at least six instruments used in today's orthoptic routines whose actions can be at least partially substituted by spinning optics instrumentation. They are: the occluder a variable fixator, the rotator, the stereoscope, the cheiroscope and the tachistoscope. The main advantage in adapting spinning optics to their use is training in one's own natural, real space, environment, home and work, not in an unnatural conventional instrument setting of twenty feet or less in the O.D.'s (optometrists) office. Occlusion, fixations and rotations have been an integral part of training for years. A non-instrument steroscope is not a new idea. Any optometrist can make a steroscope lens using base-out and base-in prisms to fuse disparate steroscopic cards. Accommodation and convergence are controlled with appropriate lenspower and prism for viewing distance.
The following classical procedures have been described in great detail by Kehl and other visual training experts. Each can be done in modified form using spinning optics, in either the home or office embodying programs of training.
1. Regular yoked prisms are constructed by placing the prism base line 90.degree. to the only Base-Apex line. The triangles' hypotenuse connects between the Apex Base line and the Apex itself.
2. Oblique yoked prisms are constructed by placing the two Base-Apex lines 90.degree. apart and whose base is described by an arc between these two equal Base-Apex lines paralleling the hypotenuse of a theoretical triangle.
To execute a base-in duction, place base-out prism (for example, eight prism diopters) on the right eye and to a similar extent, also base-out on the left. By electronically rotating the right lens clockwise and stopping the rotational movement at each of four quadrants through 360.degree. one will have spun out the right prism from base-out to base-up to base-in to base-down. Simultaneously pairing the identical left lens and spinning it counter-clockwise will also move it from a base-out to base-up to base-in to base-down cycle. One can stop the spinning optics device at each quadrant.
To execute a base-out duction, place two identical base-in prisms, one before each eye. The right can rotate this lens counter-clockwise creating in sequence base-in to base-up to base-out to base-down prism. The left eye simultaneously rotates in the opposite direction with a clockwise movement, moving in sequence that lens from base-in to base-up to base-out to base-down directions.
This is in contrast to yoking prisms which may have equal but complementary horizontal bases (base-out-right eye and base-in-left eye) each simultaneously moving clockwise or counterclockwise in synchronization. By yoking vertical prisms, one starts both right and left eye with prisms in the base-up or base-down position and rotates them synchronously. Yoking movement is only to binocularly displace movement from a preset position.